Clinical
to support the long-term results of such reparative procedures. Free gingival grafting, coro-
nally advanced flap and other root coverage concepts can also be employed. However, none are ideal in nature and almost always result in a compromised outcome. The final solution sadly, is to
use pink restorative mate- rial to disguise the form of the underlying soft tissue. It has the advantage that repeated surgical intervention is not required to create the illusion of soft height and bulk. However, blending with adjacent soft tissue can be difficult and the ‘ridge lap’ creates major issues cleaning the prosthesis, which can result in further hard and soft tissue loss.
Conclusions Although there are numerous approaches to managing soft tissues at various stages of implant treat- ment, it is best that soft tissue is optimised as early as possible in the treatment plan. Furthermore, it is the authors’
Fig 5a Good soft tissue outcome REFERENCES
Forced eruption and implant site development; soft tissue response. Theo Mantzikos, IIan Shamus.
Am J Orthod Dentofac Orthop 1997; 112:596-606
Fig 5b
Poor aesthetic outcome as a result of poor soft tissue consideration and implants placed too deeply in respect to the adjacent teeth
belief that immediate implant placement can be considered only if the gingival tissues are in the desired form and function pre-treatment. When soft tissues do require
correction, it is suggested that a delayed or submerged approach is considered to increase soft tissue bulk, allowing further tissue manipulation and a wider margin for error.
Optimizing Esthetics for implant Resotrations in the anterior Maxilla: Anaatom- ical and surgical Considera- tions. Daniel Buser, William Martin, Urs C Belser. Int J Oral MaxFac Implants 2004 19 43-61
Tarnow D Elian N Fletcher P et al. Vertical distance from the crest of bone to height of the interproximal Palla between adjacent implants. J Periodontal 2003;74: 1785-1788
Sclar A, Soft tissue and Esthetic considerations in Implant therapy (Quintes- sence 2003)
Aesthetic flap design for correction of buccal fenes- tration defects.
Steigmann M. Pract Proced Aesthet Dent. 2008
Sep;20(8):487-93; quiz 494.
Histologic evidence of a connective tissue attach- ment to laser microgrooved abutments: A canine study. M Nevins, DM Kim, SH Jun, K Guze, P Schupbach, ML Nevins. Int J Periodontics Restorative Dent, Volume 30, 2010. p. 245-255.
Deveoping Optimal peri-implant papillae within the Esthetic Zone; Guided soft tissue Augmentation. Salama H, Salama M, Garber D, Adar P. J Esthetic Dent 1995 vol7(3) 125-129
Use of the Natural tooth for soft tissue develop- ment; A case series.
Steigmann M, Cooke J, Wang HL. Int journal Periodon- tics Restorative Dent 2007; 27; 603-608
Donald Morrison, Peter Byrne & Associates
Smile with confidence Referrals for dental implants
We offer a comprehensive referral service, including refer and restore. Full patient handover and Implant Care Pack for your patients. Be involved as much or as little as you like. Introduce dental implants into your practice as we offer a full support network. CPD educational events tailored to suit your needs.
Referrals for: Single tooth / multiple tooth replacement Denture stabilisation Bone and soft tissue grafting Sinus and block augmentations
For further information, please contact our team on: 01292 268880 or visit
www.quadrantdentalpractice.co.uk
3 Barns Street, Ayr. KA7 1XB
Scottish Dental magazine 61
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